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Hepatobiliary surgery

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https://www.readbyqxmd.com/read/28940454/choledochal-cyst-with-17q12-chromosomal-duplication
#1
Radana Kotalova, Petra Dusatkova, Jana Drabova, Lenka Elblova, Tomas Dedic, Ondrej Cinek, Jan Lebl, Stepanka Pruhova
The 17q12 chromosomal region carries the HNF1B gene, mutations of which cause various conditions. When searching for HNF1B/17q12 rearrangements among children with biliary atresia and/or choledochal cysts, we identified a male proband carrying a 17q12 duplication spanning 1698 kb that included 24 genes from TBC1D3C to HNF1B. The boy presented with cholestatic jaundice at the age of 2 weeks due to a choledochal cyst sized 15 ×12 mm (type Ia according to the Todani classification). He underwent a shunt surgery consisting of a hepaticojejunostomy using Roux-en-Y loop at the age of 2 months, which led to a permanent relief of cholestasis...
September 22, 2017: Annals of Human Genetics
https://www.readbyqxmd.com/read/28936435/impact-of-enhanced-recovery-after-surgery-protocols-on-postoperative-morbidity-and-mortality-in-patients-undergoing-routine-hepatectomy-review-of-the-current-evidence
#2
Rahul Damania, Andrei Cocieru
BACKGROUND: Enhanced recovery protocols are widely used in many areas of general surgery but had a limited penetration in perioperative management of patients undergoing liver resection. Recently, multiple publications described application of enhanced recovery after surgery (ERAS) program to hepatectomy patients but their definitive role is not established or accepted by hepatobiliary surgeons. METHODS: A comprehensive literature review of published series in English language medical sources detailing ERAS program application for hepatectomy for the period of 2006-2016 is performed...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28928925/the-fortuitous-repair-of-a-common-bile-duct-injury-following-placement-of-a-percutaneous-transhepatic-cholangiogram-catheter
#3
Branum G Griswold, Jared A White
Common bile duct injuries are associated with a high rate of morbidity and mortality and are discussed frequently in the literature. These injuries may be difficult to diagnose intraoperatively and are often challenging to repair, necessitating referral to hepatobiliary surgery specialists at academic institutions. This case report highlights the management of a completely disrupted common bile duct identified post-operatively using a percutaneous transhepatic cholangiography (PTC) catheter to bridge the gap between the proximal and distal ductal injury prior to operative repair...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28911286/the-effect-of-a-surgery-specific-cardiac-output-guided-haemodynamic-algorithm-on-outcomes-in-patients-undergoing-pancreaticoduodenectomy-in-a-high-volume-centre-a-retrospective-comparative-study
#4
L Weinberg, J Banting, L Churilov, R L McLeod, K Fernandes, I Chao, T Ho, D Ianno, V Liang, V Muralidharan, C Christophi, M Nikfarjam
In this retrospective observational study performed in a high-volume hepatobiliary-pancreatic unit, we evaluated the effect of a surgery-specific goal-directed therapy (GDT) physiologic algorithm on complications and length of hospital stay. We compared patients who underwent pancreaticoduodenectomy with either a standardised Enhanced Recovery After Surgery program (usual care group), or a standardised Enhanced Recovery After Surgery program in combination with a surgery-specific cardiac output-guided algorithm (GDT group)...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28906397/clinical-and-microbiological-characteristics-of-pyogenic-liver-abscess-in-a-tertiary-hospital-in-east-china
#5
Haishen Kong, Fei Yu, Weili Zhang, Xuefen Li
Pyogenic liver abscess (PLA) is a potentially life-threatening disease affecting many parts of the world, especially Asia. In this study, we explored the clinical and microbiological characteristics of PLA in Chinese patients.A 5-year (2010-2014) retrospective review of medical records on all PLA patients who were admitted to a tertiary teaching hospital was performed.Among 217 PLA cases who were confirmed cultural positive, Klebsiella pneumonia (K pneumonia) was the most common pathogen (n = 165, 76.0%), followed by Escherichia coli (n = 21, 9...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28900442/impact-of-preoperative-three-dimensional-computed-tomography-cholangiography-on-postoperative-resection-margin-status-in-patients-operated-due-to-hilar-cholangiocarcinoma
#6
A Andert, P Bruners, C Heidenhain, F Ulmer, C D Klink, P H Alizai, C Kuhl, U P Neumann, M Binnebösel
INTRODUCTION: The purpose of this study was to analyse the value of 3-dimensional computed tomography cholangiography (3D-ERC) compared to conventional retrograde cholangiography in the preoperative diagnosis of hilar cholangiocarcinoma (HC) with special regard to the resection margin status (R0/R1). PATIENTS AND METHODS: All hepatic resections performed between January 2011 and November 2013 in patients with HC at the Department of General, Visceral and Transplant Surgery of the RWTH Aachen University Hospital were analysed...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28881553/-association-between-a-kinase-anchor-proteins-12-methylation-and-recurrence-of-hepatocellular-carcinoma
#7
Z J Liu, W Liu, C H Cui, L K Gu, B C Xing, D J Deng
Objective: To study the association between the AKAP12 promoter methylation and recurrence of hepatocellular carcinoma. Methods: A total of 142 primary liver cancer patients underwent surgery in department of Hepatobiliary surgery in Peking University Cancer Hospital from 2003 to 2009 were selected as subjects in the survey; with the inclusion criteria as hepatocellular carcinoma, no cancer cells were observed in the surgical margin(SM) samples. All patients had neither lymph nor distant metastasis at the time of surgery, and receiving complete follow-up data for at least 3 years...
September 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28880931/restrictive-intraoperative-fluid-optimisation-algorithm-improves-outcomes-in-patients-undergoing-pancreaticoduodenectomy-a-prospective-multicentre-randomized-controlled-trial
#8
Laurence Weinberg, Damian Ianno, Leonid Churilov, Ian Chao, Nick Scurrah, Clive Rachbuch, Jonathan Banting, Vijaragavan Muralidharan, David Story, Rinaldo Bellomo, Chris Christophi, Mehrdad Nikfarjam
We aimed to evaluate perioperative outcomes in patients undergoing pancreaticoduodenectomy with or without a cardiac output goal directed therapy (GDT) algorithm. We conducted a multicentre randomised controlled trial in four high volume hepatobiliary-pancreatic surgery centres. We evaluated whether the additional impact of a intraoperative fluid optimisation algorithm would influence the amount of fluid delivered, reduce fluid related complications, and improve length of hospital stay. Fifty-two consecutive adult patients were recruited...
2017: PloS One
https://www.readbyqxmd.com/read/28877110/predictors-of-intraoperative-pressure-injury-in-patients-undergoing-major-hepatobiliary-surgery
#9
Yan Chen, Li He, Wei Qu, Chen Zhang
PURPOSE: The purpose of this study was to identify risk factors associated with pressure injury (PI) development in patients undergoing major hepatobiliary surgery requiring general anesthesia. DESIGN: Retrospective medical review and analysis. SUBJECTS AND SETTING: Medical records from 803 patients undergoing hepatobiliary surgery from October 2015 to October 2016 were reviewed. The study setting was a 3400-bed military academic medical center in the northeast region of China...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#10
REVIEW
G A Stavrou, M J Lipp, K J Oldhafer
BACKGROUND: Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its' management. METHOD: A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit...
September 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28870057/-clinical-analysis-of-34-cases-with-sepsis-and-systemic-capillary-leak-syndrome
#11
H X Ma, X J Shi, Y R Liang, H D Shi, H Wang, Y S Zhao
Objective: To study the clinical characteristics of sepsis with systemic capillary leak syndrome(SCLS) and to evaluate the therapeutic effect and clinical significance of fluid therapy adjusted timely in these patients. Methods: The clinical data of 34 patients with sepsis and SCLS in the Department of Hepatobiliary Surgery ICU of General Hospital of People's Liberation Army General Hospital from July 2014 to January 2016 were retrospectively analyzed.There were 21 males and 13 females, aged from 21 to 74 years, with an average age of 56...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28860900/portal-vein-stenting-for-delayed-jejunal-varix-bleeding-associated-with-portal-venous-occlusion-after-hepatobiliary-and-pancreatic-surgery
#12
Dongho Hyun, Kwang Bo Park, Sung Ki Cho, Hong Suk Park, Sung Wook Shin, Sung Wook Choo, Young Soo Do, In Wook Choo, Dong Wook Choi
OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2-79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28853202/ursodeoxycholic-acid-effects-on-hepatic-unfolded-protein-response-apoptosis-and-oxidative-stress-in-morbidly-obese-patients
#13
Michaela Mueller, Rui E Castro, Anders Thorell, Hanns-Ulrich Marschall, Nicole Auer, Merima Herac, Cecilia M P Rodrigues, Michael Trauner
BACKGROUND AND AIMS: Ursodeoxycholic acid (UDCA) is a secondary hydrophilic bile acid (BA) used as therapy for a range of hepatobiliary diseases. Its efficacy in non-alcoholic fatty liver disease (NAFLD) is still under debate. Here we aimed to decipher molecular mechanisms of UDCA in regulating endoplasmic reticulum (ER) homeostasis, apoptosis and oxidative stress in morbidly obese patients. METHODS: In this randomized controlled pharmacodynamic study, liver and serum samples from 40 well-matched morbidly obese NAFLD-patients were analyzed...
August 29, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28832091/co-existence-of-the-double-inferior-vena-cava-with-complex-interiliac-venous-communication-and-aberrant-common-hepatic-artery-arising-from-superior-mesenteric-artery-a-case-report
#14
Vilai Chentanez, Natcha Nateniyom, Thanasil Huanmanop, Sithiporn Agthong
Variations of the arterial and venous system of the abdomen and pelvis have important clinical significance in hepatobiliary surgery, abdominal laparoscopy, and radiological intervention. A case of double inferior vena cava (IVC) with complex interiliac communication and variation of the common hepatic artery (CHA) arising from superior mesenteric artery (SMA) in a 79-year-old male cadaver is presented. Both IVCs ascended on either side of the abdominal aorta. The left-sided IVC crossed anterior to the aorta at the level of the left renal vein...
August 23, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28807031/inflammation-and-pro-resolution-inflammation-after-hepatobiliary-surgery
#15
Juan P Cata, Jose F Velasquez, Maria F Ramirez, Jean-Nicolas Vauthey, Vijaya Gottumukkala, Claudius Conrad, Bradford J Kim, Thomas Aloia
BACKGROUND: The magnitude of the perioperative inflammatory response plays a role in surgical outcomes. However, few studies have explored the mechanisms of the resolution of inflammation in the context of surgery. Here, we described the temporal kinetics of interleukin-6, cortisol, lipoxin A4, and resolvin D in patients who underwent oncologic liver resections. METHODS: All patients gave written informed consent. Demographic and perioperative surgical data were collected, along with blood samples, before surgery and on the mornings of postoperative days 1, 3, and 5...
August 10, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#16
Stéphanie Truant, Clio Baillet, Anne Claire Deshorgue, Mehdi El Amrani, Damien Huglo, François-René Pruvot
To reduce post-hepatectomy liver failure (PHLF), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently developed for patients with a limited future remnant liver (FRL). Nevertheless, high morbi-mortality rates have been reported . The current study aimed to analyze the kinetics of FRL function in patients who were offered ALPPS. Serial SPECT (99 m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) was performed in all patients before and after surgery as well as at inter-stage to quantitatively assess hepatic function [total liver (TL) and FRL]...
August 9, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28764239/single-layered-versus-double-layered-intestinal-anastomosis-a-randomized-controlled-trial
#17
Sibabrata Kar, Vandana Mohapatra, Surendra Singh, Pratap Kumar Rath, Tapas Ranjan Behera
INTRODUCTION: Gastrointestinal anastomosis is one of the most common procedures being performed in oesophagogastric, hepatobiliary, bariatric, small bowel and colorectal surgery; however, the safety and efficacy of single layer or double layer anastomotic technique is still unclear. AIM: To assess and compare the efficacy, safety and cost effectiveness of single layered versus double layered intestinal anastomosis. MATERIALS AND METHODS: This prospective, double-blind, randomized controlled comparative study comprised of patients who underwent intestinal resection and anastomosis...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28764144/variant-anatomy-of-the-hepatic-vasculature-importance-in-hepatobiliary-resections
#18
Sarika Rachel Tigga, Sandeep Saluja, Virendra Budhiraja, Rakhi Rastogi
A variant anatomy of the hepatic vasculature has a clinically significant role in hepatobiliary transplantation, resection, tumour embolisation as well as in extrahepatic abdominal surgeries involving the stomach, pancreas or gall bladder. During routine cadaveric dissection, we observed a case of unusually small calibre hepatic artery proper. An accessory hepatic artery was seen emerging from the superior mesenteric artery to the right hepatic lobe along with an accessory hepatic vein from the right hepatic lobe that drained directly into the inferior vena cava...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762583/case-of-spontaneous-splenic-rupture-caused-by-ectopic-pregnancy-in-the-spleen
#19
Bao-Qiang Wu, Feng Zhu, Yong Jiang, Dong-Lin Sun
Splenic ectopic pregnancy refers to the implantation of the oosperm in the spleen. If not diagnosed early, the results of this phenomenon would almost certainly be splenic rupture, which is equivalent to the spontaneous rupture of the spleen. If the patient has no history of trauma, it is difficult to diagnose this condition early and an explicit diagnosis is often obtained by exploratory laparotomy. We report the case of a 27-year-old woman who was admitted to the hospital due to abdominal pain and hemorrhagic shock...
August 1, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28746206/association-between-relative-liver-enhancement-on-gadoxetic-acid-enhanced-magnetic-resonance-images-and-histologic-grade-of-hepatocellular-carcinoma
#20
Young-Joo Jin, Soon Gu Cho, Kun Young Lee, Joon Mee Kim, Jin Woo Lee
We evaluated the association between histologic grade of hepatocellular carcinoma (HCC) and degree of HCC enhancement on Gd-EOB-DTPA (Gadoxetic acid, Primovist)-enhanced magnetic resonance images (MRI) in HCC patients.A total of 121 patients who underwent curative surgical resection for HCC at our institution between January 2012 and March 2015 were retrospectively analyzed. Gadoxetic acid enhanced MRI was performed in all patients before surgery. Signal intensities of HCC and peri-HCC areas were measured using regions of interest...
July 2017: Medicine (Baltimore)
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